I’m Turning 65, When Should I Apply for Medicare?
Last Updated : 08/01/20195 min read
Congratulations on approaching your 65th birthday! According to the US Census Bureau, you’re in good company. People age 65 and over in the United States are expected to reach 78 million by 2035. By 2030, Americans over 65 will equal more than 1 in 5 of the total population, according to the Census Bureau.
When Medicare was introduced in 1965, it was designed primarily for the 65+ population and since has expanded to include younger people with disabilities and certain health conditions.
You may have been enjoying age-related discounts for travel, dining, and entertainment for several years before your 65th birthday, but most people don’t become eligible for Medicare until they turn 65. According to the Kaiser Family Foundation (KFF) in 2016, about 84% of people who qualified for Medicare qualified by age and 16% qualified through disability.
When to apply for Medicare if you’re getting Social Security payments
If you’re worried that applying for Medicare requires time-consuming paperwork and detailed forms, the opposite is generally true. Most people who are already getting retirement benefits from Social Security or the Railroad Retirement Board are automatically enrolled in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
If you’re automatically enrolled in Medicare, the Centers for Medicare and Medicaid Services (CMS) will mail you a red, white and blue Medicare card three months before your 65th birthday as an early birthday gift. You will also usually receive a “Welcome to Medicare” booklet and letter which will explain options for additional Medicare coverage, among other things.
When to apply for Medicare if you’re not getting Social Security payments
If you aren’t getting retirement benefits yet, you will need to sign up manually for Medicare Part A and/or Part B generally three months before your 65th birthday.
To do this you can visit the Social Security website or contact your local Railroad Retirement Board office if that applies to you.
Since Medicare Part B comes with a monthly premium charge, you may wish to delay that coverage if you are still receiving health insurance through your employer. Most people qualify for premium-free Medicare Part A based on their work history or their spouse’s work history.
When will my Medicare benefits start?
Your Medicare Part A and Part B coverage will typically apply the first day of the month you turn 65. For example, if your 65th birthday falls May 15, your Medicare Part A and Part B coverage will generally start on May 1.
If your birthday is May 1, however, your Medicare Part A and Part B benefits will generally start the first day of the prior month, so April 1.
When to apply for Medicare Advantage?
You may have heard of Medicare Advantage from a TV advertisement, a friend, or the “Medicare and You” booklet. Medicare Advantage is another way to get your Medicare Part A and Part B benefits from a private insurance company. Medicare Advantage plans often have additional benefits for things that Original Medicare generally doesn’t cover, such as coverage for routine vision, routine hearing, routine dental, and prescription drugs. Medicare Advantage plans also are required to have an out-of-pocket maximum, which Original Medicare doesn’t have.
You can generally sign up for a Medicare Advantage plan during a 7-month period surrounding your 65th birthday. This period starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after you turn 65.
If you miss this enrollment period, there are additional enrollment periods certain times each year.
When to apply for Medicare Part D?
You may be surprised to discover that Original Medicare (Part A and Part B) doesn’t cover include coverage for most prescription drugs you take at home.
You may be able to get a Medicare Advantage plan that includes prescription drug coverage. If you decided to stick with Original Medicare, you may be able to get a stand-alone Medicare Part D Prescription Drug Plan.
You first chance to enroll in a stand-alone Medicare Part D Prescription drug plan will be the same time you first have a chance to enroll in Medicare Part D. This is the 7th period that starts 3 months before you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.
If you miss this enrollment period and then later decide you want coverage, you may be able to enroll between October 15 and December 7.
When to apply for Medicare Supplement?
Medicare Supplement insurance plans may cover copayments, coinsurance, and deductibles not paid by Original Medicare. This additional coverage could save you some anxiety about out-of-pocket costs, as Original Medicare has no out-of-pocket limit.
Medicare Supplement generally has a stricter enrollment period than Medicare Advantage and Medicare Part D. The Medicare Supplement Open Enrollment Period is only 6 months, not 7 months, and starts the month you’re 65 or older and enrolled in Medicare Part B.
If you miss this open enrollment period and apply for Medicare Supplement later, your application may be reviewed by medical underwriters. Underwriters look at your health history and may find a record of illness as a reason to deny you coverage or charge you more for coverage.
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